Don’t worry, there were about a thousand papers quoted in creating these statements, so the science seems robust. This discussion started because I had an interest in how hunter gatherers, who ate no carbohydrates, kept their brains going. What was the mechanism by which the Massai, Inuit and Sami, power their brains with glucose, if they don’t eat any carbohydrates?

Well, it seems that you can get a certain amount of glucose from fat. Fat is made up of triglycerides, and each triglyceride contains three fatty acids and one glycerol molecule. Two glycerol molecules stuck together (by the liver) makes one glucose molecule.

In short, pure fat does contain some glucose, which can be used to power the brain. However – assuming you are eating no carbs – the brain requires more glucose than can be provided by the glycerol held in triglycerides. Thus, you still need to convert some dietary protein into glucose. If you are not eating any food at all, the body will need to break down muscle to get at the protein required to synthesize glucose.

To cut a very long story short, the end point of the discussion was an agreement that you do not actually need to eat any carbohydrates to remain heathy. The body, and the brain, can get all the glucose it requires from glycerol and dietary protein.

The reason why I was interested in this issue was that ‘the absolute need for carbohydrates’ is a ‘fact’ that is thrown at me from time to time by ‘experts.’ I have always known they were wrong, because there are people e.g. the Massai, who never eat any carbohydrates, and remain far healthier than any expert I have ever cast my eyes upon. However, I wanted to be sure of the facts.

Way back in the early days of the forum - may even have been back on DI - I well remember having a very very similar discussion with the same conclusion. In fact someone - dunno who exactly - Steven (the DI guy) or TerryG, maybe Kate - just can't recall exactly who - posted some info dredged up from God knows where that in comparison with converting carbs to glucose, for fat the body needs 10% of the insulin needed and for protein needs 50%.

What I have never seen, though, is an actual scientific portrayal of when a T1 would need to actually add to their bolus in order for the body to do it.

Thus I have made the assumption (which could be erroneous since 99.9% of the carb-containing food any of us eat are NOT pure carb and always have other components in them) that either my own body gets enough carb not to bother itself with the more difficult job of converting any of the fat or protein elements of what I eat into glucose. This is fuelled by the appearance of folk (eg Patti) who deliberately eat far fewer carbs than me - who NEED to inject insulin to deal with the protein and/or fat.

However - it could quite as easily be that my carb ratio - which is obviously not calculated/observed whilst eating pure 100% carb, adjusts itself to include some for the accompanying protein and/or fat.

It is a conundrum that I don't feel capable of delving any deeper into. What I do - works pretty well for me. What Patti does - works pretty well for her. Do we actually NEED to spend any more time or brain power on it?

No, we've never really ever needed any carb. It's just a damn sight easier to carry on eating some of it, though !

Yes, I have always included an element for protein/fat, but it's more of a guesstimate. e.g. Saturday we often have a sandwich for lunch which consists of 4 rashers of streaky bacon and a fried egg between (in my case) 2 slices of Burgen, which is 24g carb but I always bolus for 30g to cover the egg and bacon as it seems to work for me.